Urinary Incontinence

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of Urinary Incontinence

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Urinary incontinence is a loss of bladder control.

Urinary incontinence (UI) is a fairly common problem that’s often brought on by actions or movements that place some type of pressure on the abdomen, such as coughing, sneezing, laughing, or performing certain types of exercise.

  • While more common in older adults, it’s not something that’s specifically associated with aging.
  • If urinary incontinence is a recurring issue, a urologist may be able to pinpoint a likely source of the problem and recommend appropriate treatments.

What Causes Urinary Incontinence?

Carbonated beverages, sugary and spicy foods, and certain medications may cause temporary urinary incontinence. Contributing factors can also include urinary tract infections and constipation. Age-related changes, menopause, pregnancy and childbirth, prostate cancer in men, tumors, and neurological disorders are additional factors or conditions that could result in

Different Types of UI

Urinary incontinence can be stress-induced. This is the kind of UI that’s usually induced by physical activity. Urge incontinence happens when there’s an urge to go immediately followed by an involuntary loss of urine. Dribbling after urination is what occurs with overflow incontinence. Mental or physical conditions like arthritis sometimes prevent someone from unbuttoning or getting to the bathroom with functional incontinence.

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How Is It Diagnosed?

In addition to a physical exam, an initial assessment may involve asking a patient to cough or perform similar actions to identify likely triggers. Further evaluation with a urinalysis and post-void residual measurement of what’s left the bladder after urination may be done to determine how the bladder is affected. Patients are sometimes asked to keep a bladder diary to help track symptoms and triggers.

Possible Treatment Options

The severity of symptoms and level of disruption to daily life usually determines what treatments are suggested. If underlying issues are involved, treatment for those conditions will also be part of overall treatment for UI, as may be the case with a patient with UI who is also diabetic.

Barring urgent circumstances, treatment normally starts with behavioral modifications such as bladder training, learning to go once and then wait a few minutes to try again to ensure the bladder is fully emptied (double voiding), and scheduling bathroom visits.

Pelvic floor muscles may be strengthened with electrical stimulation. Anticholinergics, alpha blockers (for men), and low-dose topical estrogen (for women) are some of the medications that may help with symptoms. Treatment possibilities also include:

  • Urethral inserts to minimize bladder stimulation during physical activity
  • Transurethral bulking agents around the urethra to control leakage
  • Nerve stimulators that control nerve impulses around the bladder
  • Botox injections
  • Protective garments

Surgery to minimize to stop leakage may be recommended if interventional or non-surgical options aren’t effective. With a sling procedure, synthetic materials are used to keep the urethra closed. A bladder neck suspension provides extra support to the urethra and bladder neck. Women may also be treated with prolapse surgery performed through the vagina to reinforce tissues. An artificial urinary sphincter with a fluid-filled ring that’s activated to a valve under the skin is sometimes recommended for men with UI.

Not entirely preventable, urinary incontinence can sometimes be avoided by keeping weight within a normal range, avoiding smoking and acidic foods, and eating more fiber-rich foods to minimize constipation. Some patients benefit from pelvic floor exercises that strengthen muscles that directly or indirectly support the bladder and other parts of the urinary tract.

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